Bethany N Perry, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6268-33 Issued in WI

Practice address

130 Corporate Dr
Beaver Dam, WI 53916-3116

Phone

(920) 877-3102

Fax

(920) 855-8790

NPI assigned

Apr 8, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Beaver Dam (MMC-BD) Hospital, Beaver Dam, WI, CCN 520076
• Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037
• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bperry261196@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beaver Dam Community Hospitals Inc

  • General Acute Care Hospital
  • Beaver Dam, WI
  • NPI 1023187416
  Care Compare affiliation
• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1508184896

  Hospital

  Care Compare affiliation
• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation
• MCHS Hospitals Inc

  • Rural Acute Care Hospital
  • Marshfield, WI
  • NPI 1942749387
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1770979650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163116",
            "telephone_number": "920-877-3102",
            "fax_number": "920-855-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163116",
            "telephone_number": "920-877-3102",
            "fax_number": "920-855-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "BETHANY",
        "middle_name": "N",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6268-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770979650",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bperry261196@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bperry261196@direct-ehr-ssmhc.com",
            "address_1": "705 S University Ave Ste 500",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "705 S University Ave Ste 500",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bperry261196@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bperry261196@direct-ehr-ssmhc.com",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pain Centers of Wisconsin - Beaver Dam, LLC
• Paul Anthony Palmer, MD
• Abigail L Paspalofski, DPT
• Tara Passow, M. D.
• William Perego
• Jayson Persch, PHARMD
• Andrea Petersen, MSW
• Elizabeth Michael Peterson, M.D.
• Emily Peterson, MD
• Eugene P Philipp Jr., PSYD

• Nurse Practitioner in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.